What should I discuss with my healthcare provider before taking neostigmine (Prostigmin Bromide)?

You should not use this medication if you are allergic to neostigmine or pyridostigmine (Mestinon), or if you have a bladder or bowel obstruction, or a serious stomach disorder called peritonitis.

To make sure you can safely take neostigmine, tell your doctor if you have any of these other conditions:

asthma;

kidney disease;

slow heartbeats or other heart rhythm disorder;

high blood pressure, heart disease, coronary artery disease;

an ulcer or other serious stomach disorder;

overactive thyroid; or

a history of seizures.

FDA pregnancy category C. It is not known whether neostigmine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. You should not take neostigmine during late pregnancy.

It is not known whether neostigmine passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are using neostigmine.

How should I take neostigmine (Prostigmin Bromide)?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Take this medicine with food or milk if it upsets your stomach.

Do not crush, chew, or break an extended-release tablet. Swallow it whole. Breaking or opening the pill may cause too much of the drug to be released at one time.

The amount and timing of this medicine is extremely important to the success of your treatment. Carefully follow your doctor's instructions about how much medicine to take and when to take it. You may need to take neostigmine at evenly spaced intervals around the clock.

Your doctor may occasionally change your dose to make sure you get the best results. You may be asked to keep a daily record of when you took each dose and how long the effects lasted. This will help your doctor determine if your dose needs to be adjusted.

If you need surgery, tell the surgeon ahead of time that you are using neostigmine. You may need to stop using the medicine for a short time.